Douglas Skarada, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

23186 Issued in OR

Practice address

340 Vista Ave SE Ste 100
Salem, OR 97302-4546

Phone

(503) 584-1174

Fax

(503) 584-1330

NPI assigned

Jun 15, 2005

Last updated

Feb 6, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR, WA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Otolaryngology

Education

Duke University School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Modern Nose Clinic LLCGroup PAC ID 5597036897, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Modern Nose Clinic LLC

  • Otolaryngology Physician
  • Salem, OR
  • NPI 1851825566

  WA

  Medicare reassignment Care Compare group NPD Authorized official
• Modern Nose Clinic LLC

  • Otolaryngology Physician
  • Salem, OR
  • NPI 1043874696
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549411200000",
    "number": "1770588949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 VISTA AVE SE STE 100",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024546",
            "telephone_number": "503-584-1174",
            "fax_number": "503-399-1229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 VISTA AVE SE STE 100",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024546",
            "telephone_number": "503-584-1174",
            "fax_number": "503-584-1330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKARADA",
        "first_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2019-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OR",
            "license": "23186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287190",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Purcell Sisto, QMHP, CADC-II
• Jean Kathryn Sitkei, PT
• Sara Cowart Sitz, ST
• Lauren Gabrielle Siverly
• Janelle Skalla, LMT
• Philip Charles Skelding, MD
• Michael Sketch, CGAC II, CGRM
• Skillbridge Residential Treatment Home LLC
• Benjamin James Skinner, ASSOCIATE THERAPIST
• Reilly Skinner, PSS

• Otolaryngology Physician in Salem, OR
• Providers in Salem, OR by specialty
• Otolaryngology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.